Versicherungstechnische Gesichtspunkte auf die finanziellen Fragen der Lebensversicherung

Kapitel I. Bibliographisches

Die versicherungstechnische Litteratur hat sich verhältnismässig wenig mit den aktuariell-finanziellen Fragen befasst. Bemerkenswert ist es deshalb, dass die meisten von den bis jetzt abgehaltenen neun internationalen Aktuarkongressen die eine oder die andere Frage aus oben erwähntem Gebiet in ihrem Programm aufgenommen haben. So z. B. beschäftigte sich der erste Kongress, der 1895 in Brüssel tagte, mit dem Gegenstand: “Des mesures qui pourraient être prises par les institutions qui contractent des engagements à long terme, pour se premunir contre les conséquences des variations du taux d intérêt.” Der Kongress im Jahre 1900 in Paris hatte in seinem Programm das Thema: “Méthodes à employer pour evaluer les titres mobiliers compris dans l'actif d'une Société quelconque.” Bei dem New Yorker Kongress 1903 wurde die Prage über “The Probable Future Course of the Rate of Interest” erörtert. Dem Wiener Kongress 1909 war die Frage über “Kapitalsanlagen der Versicherungsgesellschaften mit besonderer Berücksichtigung der modernen Entwickelung” zur Behandlung vorgelegt. Das Programm des Londoner Kongresses 1927 enthielt das Thema “Currency Depreciation as affecting Life Assurance Contracts”.     

AIDS and African Development

Because AIDS affects primarily the most productive age groupand is fatal and widespread, it will have a larger impact onAfrican development than other more common diseases. Infectionrates are higher in urban than in rural areas, and studies suggestthat they are highest among urban high-income, skilled men andtheir partners. Macroeconomic models show that the greater theinfection rate among educated workers and the greater the propensityto finance medical care out of savings, the more detrimentalis the impact of AIDS on the growth of per capita income. Regardlessof the macroeconomic effect, most households and businessesdirectly affected by AIDS will be economically worse off, atleast in the short run. It is not clear, however, what effectAIDS will have on poverty in Sub-Saharan Africa or on incomeinequality. Governments need to assess the potential economicimpact of AIDS, implement cost-effective programs to mitigatethe impact, and target prevention programs to the economic sectorsmost sensitive to HIV infection.      

AIDS is your business

If your company operates in a developing country, AIDS is your business. While Africa has received the most attention, AIDS is also spreading swiftly in other parts of the world. Russia and Ukraine had the fastest-growing epidemics last year, and many experts believe China and India will suffer the next tidal wave of infection. Why should executives be concerned about AIDS? Because it is destroying the twin rationales of globalization strategy-cheap labor and fast-growing markets--in countries where people are heavily affected by the epidemic. Fortunately, investments in programs that prevent infection and provide treatment for employees who have HIV/AIDS are profitable for many businesses--that is, they lead to savings that outweigh the programs' costs. Due to the long latency period between HIV infection and the onset of AIDS symptoms, a company is not likely to see any of the costs of HIV/AIDS until five to ten years after an employee is infected. But executives can calculate the present value of epidemic-related costs by using the discount rate to weigh each cost according to its expected timing. That allows companies to think about expenses on HIV/AIDS prevention and treatment programs as investments rather than merely as costs. The authors found that the annual cost of AIDS to six corporations in South Africa and Botswana ranged from 0.4% to 5.9% of the wage bill. All six companies would have earned positive returns on their investments if they had provided employees with free treatment for HIV/AIDS in the form of highly active antiretroviral therapy (HAART), according to the mathematical model the authors used. The annual reduction in the AIDS "tax" would have been as much as 40.4%. The authors' conclusion? Fighting AIDS not only helps those infected; it also makes good business sense.     

A case of AIDS

"A case of AIDS" by Richard S. Tedlow and Michele S. Marram explores the issues involved in managing an HIV-infected employee over time. When an opening on his team occurs, should Greg hire Joe despite his HIV infection? How should Greg handle the issue of confidentiality? And when Joe asks for a promotion, how should Greg manage the issue of Joe's long-term career? Three experts discuss each stage of the case as it unfolds.     

On excluding the AIDS crisis

Many insurers are imposing restrictions on AIDS coverage during policy renewal in the form of outright exclusions or as caps on benefits levels.     

Nothing prepared me to manage AIDS

Articles and seminars about AIDS in the workplace are not adequate preparation for the genuine problems faced by actual managers in real organizations. There are no easy, win-win solutions to the impossible dilemmas AIDS presents, only various forms of damage control and, at best, more or less humane compromises. Gary Banas knows. Over a period of four years, two of his direct reports developed AIDS, and he watched them suffer through debility, slowly deteriorating performance, and eventual death. He also watched the gradual decline of their subordinates' productivity and morale. He found that, to different degrees, both men refused to acknowledge their illness and their decreasing organizational effectiveness. One of them resisted the author's efforts to give him an easier job at no loss in salary. Both insisted on confidentiality long after the rumor mill had identified their problem. In the course of these two consecutive ordeals, Banas discovered that AIDS patients fall into no single, neat category. AIDS is not an issue but a disease, and the people who get it are human beings first and victims second. He also learned that AIDS affects everyone around the sick individual and that almost every choice a manager makes will injure someone. Finally, he came to understand that while managers have an unequivocal obligation to treat AIDS-afflicted employees with compassion and respect, they have an equally unequivocal obligation to keep their organizations functioning. "Don't let anyone kid you," Banas warns. "When you confront AIDS in the workplace, you will face untenable choices that seem to pit your obligation to humanity against your obligation to your organization.(ABSTRACT TRUNCATED AT 250 WORDS)     

AIDS policy and psychology: a mechanism-design approach

Economic theorists have given little attention to health-related externalities, such as those involved in the spread of AIDS. One reason for this is the critical role played by psychological factors, such as fear of testing, in the continued spread of the disease. We develop a model of AIDS transmission that acknowledges this form of fear. In this context we design a mechanism that not only encourages testing but also slows the spread of the disease through voluntary transmission. Our larger agenda is to demonstrate the power of psychological incentives in the public health arena.